Beaulieu, Nicholas Jean

Beaulieu, Nicholas Jean is an sole proprietor health care provider with primary practice located at 920 Ponce De Leon Ave Ne 920 Ponce De Leon Ave, Atlanta GA 30306-4212. He recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as his primary health care specialty. Beaulieu, Nicholas Jean can be contacted via phone (404) 815-1957.

Contact Information

Primary practice address
920 Ponce De Leon Ave Ne 920 Ponce De Leon Ave Atlanta GA 30306-4212
Phone: (404) 815-1957
Fax: (404) 815-1954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 42176 Georgia

Profile Details

NPI number 1679680557
LBN Legal business name Beaulieu, Nicholas Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Sep 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679680557 NPPES
Georgia MEDICAID 00717076E

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